Authors:

Department of Microbiology, Medical University of Warsaw, Warsaw, Poland,

Purpose: Late bacterial infections (LBIs) after esthetic facial augmentation using hyaluronic acid (HA) fillers are relatively rare yet severe complications that are difficult to treat. No adequate treatment standards have hitherto been formulated. We have bridged this gap by formulating a treatment scheme based on the principles of treating foreign-body implantation-related infections and treating bacterial growth in the form of biofilm. Read More

Authors:

Background: The popularity of dermal fillers has grown rapidly in the last few years for facial rejuvenation. Plasma gel is an autologous gelatinous material that is prepared from the patient's own platelet poor plasma.

Objective: To evaluate the clinical efficacy and safety of plasma gel injection as a dermal filler for facial rejuvenation. Read More

Authors:

Department of Oculoplastics, University of California San Diego, San Diego, California.

Newer understanding of volume loss as a critical component of facial aging and the integration of volume replacement into the surgical and nonsurgical therapeutic algorithm is arguably the most significant recent development in the field of facial rejuvenation. As all structural tissues play a role in the aging face, restoring youthful characteristics (or establishing them where they are congenitally absent) starts from the skeletal framework and builds progressively to the canvas of the face. The purpose of this article is to provide an introduction and brief summary of some of the current concepts concerning facial anatomy and the anatomy of facial aging, which serve as the basis for predictable and reproducible results with the use of injectable fillers. Read More

Authors:

Background: Calcium hydroxylapatite (CaHA, Radiesse®) with integral 0.3% lidocaine (CaHA(+)) has recently been approved for use in aesthetic medicine. This study assessed the performance of CaHA(+) in subjects undergoing treatment for facial volume loss and evaluated subject and physician satisfaction. Read More

Authors:

Department of Maxillofacial Plastic Surgery, Division of Dental and Maxillofacial Surgery and the Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy.

Background: The bad outcomes of a facial trauma could have a strongly negative psychological impact and compromise patient's quality of life. Unfortunately, surgery cannot always solve this problem or give an acceptable result.

Objectives: Aesthetic medicine treatments with injectables may provide a solution that is minimally invasive and more accepted by the patients in improving bad outcomes after facial trauma. Read More

Authors:

The use of fillers for cosmetic improvement is increasing. As a result, the number of complications is rising too. Being confronted with facial nodules of unknown origin, many doctors who are not involved in cosmetic medicine are not inclined to consider filler complication as part of a differential diagnosis. Read More

Background: Injection of soft-tissue fillers into the facial fat compartments is frequently performed to ameliorate the signs of facial aging. This study was designed to investigate the functional anatomy of the deep facial fat compartments and to provide information on the effects of injected material in relation to age and gender differences.

Authors:

Department of Family Medicine, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA. Electronic address:

Plastic surgery is a broad field, including maxillofacial surgery, reconstruction after injuries, hand surgery, and skin flaps and grafts, but the most common procedures for women are liposuction and body contouring, breast surgery, and facial cosmetic procedures. Techniques of face and brow lifts, blepharoplasty, and rhinoplasty are discussed as well as botulinum toxin and filler injections, and laser and pulsed light techniques that may delay or eliminate the need for surgery. Comparison of the surgeries for breast reconstruction, reduction, augmentation, and mastopexy is discussed. Read More

Authors:

Calcium hydroxylapatite (CaHA) is a commonly used soft tissue filler for aesthetic facial improvement, in particular for the lower and mid-face. The golden standard for upper facial filler indications is hyaluronic acid (HA) injection. In this report we investigate the safety, efficacy and complication rates after injections of CaHA to the upper third of the face using a variety of different techniques. Read More

Background: Calcium hydroxylapatite (CaHA) is approved to correct moderate-to-severe wrinkles and folds and soft-tissue volume loss in the face and hands. More recently, subdermal injection using diluted CaHA has been used to improve skin laxity.

Objective: To review evidence for the safe and effective use of diluted CaHA in the face and body and provide best practice recommendations. Read More

Authors:

Background: Worldwide, the brow is the most common facial site to receive aesthetic treatment. However, the forehead above the brows has been comparatively less well studied with respect to both neuromodulators and fillers. Age-related remodeling of the forehead with loss of facial bone has been demonstrated on detailed radiographic studies. Read More

Authors:

Background: Loss of the viscoelastic properties of the skin is a primary sign of aging and contributes to the appearance of wrinkles. Hyaluronic acid (HA) fillers are one of the most commonly used treatments for age-related soft-tissue reduction and volume loss. Evidence is also emerging that HA fillers rejuvenate the skin. Read More

Background: Although many facelift techniques incorporate fat grafting with tissue repositioning and removal, the intermediate and long-term changes in facial volume after these techniques is unknown. Whereas fillers for facial volume have predictable life spans, we know little about the facial volume changes following fat grafting with facelift surgery.

Objectives: To track the short-term and long-term effects on midfacial volume change. Read More

Background: Over the past decade, cosmetic injections of dermal fillers or fat have become a popular procedure in facial rejuvenation in an overconsuming society. However, complications such as arterial embolism and occlusion can occur even with experienced injectors, especially in high-risks zones namely the glabella, the nasal dorsum or the nasolabial fold. The aim of this study was to define the vascular danger zones of the infraorbital area in order to provide guidelines helping avoid them. Read More

Authors:

The periorbital and forehead regions are among the most expressive parts of the face. A thorough understanding of the complex facial anatomy and aesthetic norms are essential when evaluating and treating a patient for facial brow rejuvenation. Not only will knowledge of the anatomy enhance facial injection and surgical outcomes, but will also diminish potential complications. Read More

Hyaluronic acid (HA) plays multifaceted role in regulating the various biological processes such as skin repairmen, diagnosis of cancer, wound healing, tissue regeneration, anti-inflammatory, and immunomodulation. Owing to its remarkable biomedical and tissue regeneration potential, HA has been numerously employed as one of the imperative components of the cosmetic and nutricosmetic products. The present review aims to summarize and critically appraise recent developments and clinical investigations on cosmetic and nutricosmetic efficacy of HA for skin rejuvenation. Read More

Authors:

Injectable fillers have become one of the most performed aesthetical treatments worldwide over the past two decades. They are frequently applied to the face, offering effective and safe alternatives to more invasive surgical procedures. Nevertheless, there are serious risks associated with filler-based treatment. Read More

Authors:

Department of Dermatology and Venereology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

Among several skin fillers developed in recent decades, hyaluronic acid (HA) fillers have become the material of choice. They are safe, long-lasting, not immunogenic, and cost effective, and they can be removed with hyaluronidase. Unfortunately, early and delayed complications can also occur following HA filler injection. Read More

Authors:

A 51-year-old woman presented with no light perception vision of the right eye 12 hours after another provider injected calcium hydroxylapatite into the glabella and dorsum of the nose. Exam and fluorescein angiography demonstrated optic nerve edema and choroidal hypoperfusion consistent with ischemia of the posterior ciliary circulation. The central retinal circulation appeared intact. Read More

Authors:

Skin necrosis is a rare but severe potential complication after injection of hyaluronic acid (HA). Based on the understanding of the causes and mechanisms of this complication, many precautions have been proposed. Still, this adverse reaction happened from time to time. Read More

Authors:

Volumetric rejuvenation with fillers is a minimally invasive technique used for facial volume restoration. Volume restoration demands adequate knowledge of fat pads and vascularity of the face and the understanding of the depletion patterns. Volumetric restoration with injectable has witnessed a paradigm shift in the last decade with a global rejuvenation, acquiring a predominant emphasis over focal wrinkle filling to restore the depletion pattern of facial fat layers. Read More

Authors:

This study reports on an empirically underdocumented practice in contemporary aesthetic enhancement culture, the self-injection of unregulated DIY Botox and dermal filler kits purchased online. Data were collected from 4 online discussion forums containing disclosures in relation to use of DIY kits and analyzed using ethnographic content analysis. Motivation to source DIY Botox and dermal fillers online was grounded in desire to avoid financial cost of professional services and a lack of confidence in practitioners. Read More

Authors:

Injectable fillers and neuromodulators are used for a range of indications pertaining to the correction of facial aging and disfigurement. Fillers can correct soft tissue loss, depressed scars, and atrophy or asymmetry induced by systemic or local disease. Neuromodulators correct muscle-mediated skin creases, reshape the face, and address right-left functional asymmetry. Read More

Authors:

Cosmetic dermatologic surgery has evolved to be a minimally invasive field that addresses patient concerns with a multimodal approach while minimizing adverse events and downtime. Within the armamentarium of dermatologic surgery, injections of soft tissue augmentation materials and neuromodulators are key tools for recontouring the aging face. Treatment of the individual patient is preceded by a comprehensive consultation that elicits patient concerns and preferences. Read More

Authors:

Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada Pacific Derm, Vancouver, British Columbia, Canada Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Authors:

Bangkok and Nakhon Pathom, Thailand; and Liverpool, United Kingdom From the Department of Anatomy, Faculty of Medicine, and the Chula Soft Cadaver Surgical Training Center, Chulalongkorn University and King Chulalongkorn Memorial Hospital; the Department of Basic Medical Science, Faculty of Medicine Vajira Hospital, Navamindradhiraj University; the College of Health Sciences, Christian University; and the School of Life Sciences, Faculty of Health and Life Sciences, University of Liverpool.

Background: The tear trough is a significant sign of periorbital aging and has usually been corrected with filler injection. However, the arterial supply surrounding the tear trough could be inadvertently injured during injection; therefore, this study aimed to evaluate the nearest arterial locations related to the tear trough and investigate the possibility of severe complications following filler injection.

Methods: Thirty hemifaces of 15 Thai embalmed cadavers were used in this study. Read More

Authors:

Dr. Werschler are with Yardley Dermatology Associates in Yardley, Pennsylvania.

Facial volume loss can substantially impact self-perception of the affected individual and his to her social/professional interactions and opportunities. Persons who are perceived as more youthful and attractive are rated as nicer, more energetic, healthier, and more likely to be productive than those perceived to be older and unattractive. The goal of this study was to assess the changes in emotional and functional status of subjects treated with 2 to 4 monthly PLLA injections to the upper, mid, and lower face. Read More

Authors:

With their high elasticity and viscosity, calcium hydroxylapatite (CaHA) fillers are now widely used to treat age-related or hereditary facial soft tissue volume deficits. CaHA filler volume augmentation is further enhanced by its ability to stimulate neocollagenesis and improve skin quality. However, its high viscosity and cohesivity may hinder its spread and distribution, while its injection by cannula or needle may require moderate extrusion force and lead to uneven distribution or focal accumulation in tissues. Read More

Updates on managing some of the most common dermatologic conditions for which patients seek care illuminated presentations at the Skin Disease Education Foundation's 42nd Annual Hawaii Dermatology Seminar®. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. Treatment of psoriasis has continued to advance, with three interleukin (IL)-17 antagonists approved by the US Food and Drug Administration (FDA) and a fourth in phase 3 trials. Read More

Hyaluronic acid (HA) injection is a popular nonsurgical, facial rejuvenating procedure. Due to the rapidly expanding use of HA injections, significant potential complications have also increased in frequency. Among these complications, the rare but most devastating one is arterial occlusion, which can result in skin necrosis or blindness. Read More

Authors:

Rhinoplasty is a commonly performed cosmetic surgery in Asia. Rhinoplasty using filler is preferred because has fewer side effects and shorter down time. The part of external nose between the skin and bone or cartilages consists of 4 layers. Read More

Authors:

BACKGROUND Dermal fillers are increasingly used for medical and aesthetic purposes in clinical practice. Common complications following filler injections include bruising, itching, infections, allergic reactions, and tissue necrosis. This case is the first report of Herpes simplex virus type 1 (HSV-1) encephalitis as a possible complication of dermal filler injection. Read More

Authors:

Tokyo and Kawasaki, Japan From the Departments of Plastic, Oral and Maxillofacial Surgery and Plastic Surgery, Teikyo University School of Medicine; and University Hospital, Mizonokuchi.

Background: Because subcutaneously injected hyaluronic acid filler is absorbed over 6 months to 1 year after the treatment of facial wrinkles, frequent retreatment may be required. However, persistent long-term effects are often clinically observed when hyaluronic acid filler is injected as a bolus for facial augmentation. Therefore, the authors investigated, over time, the changes in volume and histologic features of subcutaneous bolus injections of hyaluronic acid. Read More

Authors:

King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Background: The widespread desire to maintain youth and beauty with minimally invasive procedures made the use of soft tissue fillers an attractive option to correct numerous aesthetic problems. However, many complications have emerged recently especially with the use of non-FDA-approved permanent materials. In this case report, we are demonstrating the effective management of a patient with Brucella isolated from a facial abscess at the site of prior permanent filler injection done 17 years ago. Read More

Background: The demand for minimally invasive cosmetic procedures has continued to rise, especially in Germany, yet few studies have examined this patient population. The literature in Germany has repeatedly voiced the speculation that users of minimally invasive, skin-rejuvenating procedures displayed a higher tendency toward dysmorphic behavior patterns or, respectively, other abnormal personality traits.

Objectives: The aim of this study was to investigate body image, personality traits, quality of life, and socioeconomic parameters in users of botulinum toxin and/or facial fillers. Read More

Authors:

Introduction: Lip augmentation procedures with hyaluronic acid dermal fillers have become increasingly popular worldwide because full lips are often considered beautiful and youthful. The goal of a lip augmentation procedure is to create smooth lips with adequate volume and a natural appearance. Various techniques for lip augmentation have been utilized and described. Read More

Hyaluronic acid dermal fillers are becoming popular all over the world, but due to the presence of many blood vessels in the face, there is always a small possibility of vascular complications. We present a case with the ischemic involvement of chin and neck skin after accidental submental artery involvement after hyaluronic acid filler injection for chin region. Impending skin necrosis on the chin and upper neck on the right side was diagnosed quickly by observing the skin changes in the immediate postfiller phase. Read More

Authors:

Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, NY.

The recent approval in 2015 of Radiesse for injection into the hand by the FDA has spurred an increase in interest among patients and clinicians in nonsurgical hand rejuvenation using fillers. Application of the same techniques used to treat the face to the dorsum of the hands does not account for the unique nature of the skin and underlying anatomy, and can lead to suboptimal outcomes and an increased risk of adverse events such as the formation of nodules. Here, the authors discuss dilution strategies and injection techniques for hand rejuvenation using Radiesse for optimal patient safety and aesthetic outcomes. Read More

Authors:

Seoul, Republic of Korea; and Bangkok, Thailand From the Division of Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institution, BK21 PLUS Project, Yonsei University College of Dentistry; and the Chula Soft Cadaver Surgical Training Center and Department of Anatomy, Faculty of Medicine, Chulalongkorn University.

Background: Understanding the topography of the blood vessels distributed around the nasolabial fold region is essential for ensuring the safety of dermal filler injections into the nasolabial fold. The purpose of this study was to provide anatomical information on the infraorbital artery distribution and its relationship with the facial artery for use in clinical procedures involving filler injection during nasolabial fold augmentation.

Methods: The infraorbital artery was investigated in the nasolabial fold region divided into zones I to XII based on clock-hour meridians centered on the infraorbital foramen. Read More

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